Progress | Growth

Expanding Horizons

Growth Initiatives

Government IT Services

Palmetto GBA began work to establish a practice that could competitively bid on the abundance of government IT opportunities. Under this practice, we’re working to hone expertise in:

Traditional IT services

business rules and requirements management

applications/software design and development

systems integration

software/applications operations and maintenance

software testing

Niche IT services

cybersecurity

data availability/interoperability/integration

telehealth/telemedicine technology platforms

Data Analytics Services and Technology

To meet the expanding data analytics and technology needs of federal and state government agencies, as well as those of employers, health plans, and providers, we also deepened expertise and infrastructure in these areas.

New Business

QIC Demonstration Evaluation Contractor (QDEC)

Palmetto GBA acquired tasks on the QDEC contract as a subcontractor to IMPAQ International. The purpose of the QDEC is to determine whether further engagement between suppliers and Qualified Independent Contractors (QICs) will improve understanding of claim denial reasons and ultimately result in more proper claims submission at the A/B Medicare Administrative Contractor level. Under the contract, Palmetto GBA performs reviews of reconsideration decisions for quality and accuracy and assists with data analytics. The five-year demonstration began in January and will continue through December 31, 2020.

Transformation Twenty-One Total Technology Next Generation (T4NG) Program

Palmetto GBA, as a subcontractor to Leidos, was awarded the T4NG Program contract vehicle. Under the vehicle, the U.S Department of Veterans Affairs sought to acquire IT services to integrate systems, networks, and software including computer systems, program planning and management, systems and software engineering, cyber security, operations and maintenance, and facility support.

Strategic Partner Acquisition of Resources Contract (SPARC)

Palmetto GBA, as a subcontractor to QSSI, was awarded a SPARC large contract. The purpose of this contract is to provide a wide range of IT professional services to the federal government. Palmetto GBA also was awarded SPARC small contracts with three primes – DCCA, Liberty and Strategi.

Renewed Contracts

Competitive Bidding Implementation Contractor (CBIC)

Palmetto GBA again was selected as the Competitive Bidding Implementation Contractor to continue operations and maintenance of the durable medical equipment competitive bidding program.

Third Party Administrator (TPA) for Medicare Part D

Palmetto GBA, the incumbent, was selected as the TPA for Medicare Part D. The TPA of the Medicare Coverage Gap Discount Program is the single point of contact between the pharmaceutical manufacturers, including their third-party vendors, and the Part D sponsors participating in the discount program.

Federal Employee Program (FEP) for Blue Cross Association

Palmetto GBA again was awarded a contract to provide pricing for FEP claims to the Blue Cross Association on August 29, 2016. The contract requires that FEP claims be priced the same as Medicare Fee-for-Service claims.

Palmetto GBA is a leading provider of high-volume claims and transaction processing, contact center operations and technology services to the federal government. Our core business is to provide support to the Centers for Medicare & Medicaid Services (CMS), Medicare beneficiaries and Medicare providers.